Chronic
Radiation Enteritis

Clinical

Chronic radiation
enteritis is caused by ischemia associated with endarteritis. Five percent of
patients receiving 4500-5000 cGy of radiation will develop chronic radiation
enteritis. Symptoms include abdominal pain, nausea, vomiting, diarrhea (which
may or may not be bloody), and they can manifest anywhere from 6 months to 25
years after exposure. Clinical and radiological findings can mimic
inflammatory or infectious disease or recurrent tumor.

Radiological

Imaging findings are
related to both active ischemia and chronic changes (fibrosis). Active
ischemia causes edema and hemorrhage into the bowel wall, leading to fold
thickening and separation of bowel loops. Fibrosis leads to strictures, sinus
tracts, and fistulae. Advanced disease can cause obstruction.